Unraveling the Signaling Secretome of Platelet-Rich Plasma: Towards a Better Understanding of Its Therapeutic Potential in Knee Osteoarthritis (original) (raw)
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Platelet-rich plasma for managing pain and inflammation in osteoarthritis
Nature Reviews Rheumatology, 2013
| Osteoarthritis (OA) is a common disease involving joint damage, an inadequate healing response and progressive deterioration of the joint architecture. Autologous blood-derived products, such as plateletrich plasma (PRP), are key sources of molecules involved in tissue repair and regeneration. These products can deliver a collection of bioactive molecules that have important roles in fundamental processes, including inflammation, angiogenesis, cell migration and metabolism in pathological conditions, such as OA. PRP has anti-inflammatory properties through its effects on the canonical nuclear factor κB signalling pathway in multiple cell types including synoviocytes, macrophages and chondrocytes. PRP contains hundreds of different molecules; cells within the joint add to this milieu by secreting additional biologically active molecules in response to PRP. The net results of PRP therapy are varied and can include angiogenesis, the production of local conditions that favour anabolism in the articular cartilage, or the recruitment of repair cells. However, the molecules found in PRP that contribute to angiogenesis and the protection of joint integrity need further clarification. Understanding PRP in molecular terms could help us to exploit its therapeutic potential, and aid the development of novel treatments and tissue-engineering approaches, for the different stages of joint degeneration.
2020
Background: Osteoarthritis (OA) is a multifactorial disease that commonly affects the knee. Tumor necrosis factor-α (TNF-α) is able to regulate inflammation in OA. Macrophage migration inhibitory factor (MIF) may be involved in the pathophysiology of arthritis. Platelet-rich plasma (PRP) may reduce pain associated with OA. The current study aimed to assess the possible therapeutic effects of PRP in patients with knee OA of various severities. Methods: A prospective study was performed on 90 patients were included and categorized into mild (30 cases, moderate (30 cases) and severe (30 cases) knee OA. Three intra-articular (I.A) injections of PRP, 2 weeks a part, were received. Pain score and MRI Osteoarthritis Knee Score (MOAKS) were assessed. Serial synovial fluid cytokines assays in the form of Tumor necrosis factor-α (TNF-α) and Macrophage migration inhibitory factor (MIF), were performed using commercially available ELISA assay kits. The assays were performed pre-injection (S1), ...
Platelet-Rich Plasma Therapy: An Effective Approach for Managing Knee Osteoarthritis
Cureus, 2023
Platelet-rich plasma (PRP) is a promising non-invasive therapeutic intervention for knee osteoarthritis (KOA) that has generated significant interest due to anecdotal accounts of its efficacy, resulting in reduced recovery time in various orthopedic interventions. This systematic review examines the effectiveness of PRP in managing KOA. Specifically, it seeks to determine the extent to which PRP can treat KOA patients effectively, alleviate KOA symptoms, and improve patient outcomes. Additionally, the review aims to identify the optimal concentration and composition of PRP required to achieve therapeutic results in KOA. Furthermore, the review investigates whether PRP can modify the synovial environment structurally and immunologically to improve outcomes in KOA patients. We conducted a comprehensive literature search on PubMed, Orthogate, Clinicaltrials.gov, and Embase of clinical trials investigating PRP treatment in KOA patients in the last five years. The results indicated that PRP is effective in treating KOA patients. Evidence shows that PRP therapy can alleviate pain, enhance joint function, increase range of motion, and improve mobility in KOA patients. PRP was effective in treating KOA when the mean platelet concentration of PRP treatment was 4.83 to 5.91 times higher than the baseline whole blood platelet concentration. However, studies investigating PRP with a mean platelet concentration of 3.48 to 4.04 times higher than baseline failed to demonstrate statistically significant improvements. PRP therapy slowed down KOA progression, which validates its effectiveness in impeding further structural damage and arresting the degenerative impact of the disease. Nonetheless, further investigation is necessary to examine how PRP therapy can modify the progression of the disease. Furthermore, future research should identify the most effective platelet concentration levels that provide optimal symptom relief. There is a need for further research to identify the specific PRP configuration that is most pertinent in a clinical setting, as there is a lack of standardization in PRP manufacturing protocols, including the variety of experimental setups and dosing schedules utilized in different studies.
The Effect of Platelet-Rich Plasma on the Intra-Articular Microenvironment in Knee Osteoarthritis
International Journal of Molecular Sciences
Knee osteoarthritis (KOA) represents a clinical challenge due to poor potential for spontaneous healing of cartilage lesions. Several treatment options are available for KOA, including oral nonsteroidal anti-inflammatory drugs, physical therapy, braces, activity modification, and finally operative treatment. Intra-articular (IA) injections are usually used when the non-operative treatment is not effective, and when the surgery is not yet indicated. More and more studies suggesting that IA injections are as or even more efficient and safe than NSAIDs. Recently, research to improve intra-articular homeostasis has focused on biologic adjuncts, such as platelet-rich plasma (PRP). The catabolic and inflammatory intra-articular processes that exists in knee osteoarthritis (KOA) may be influenced by the administration of PRP and its derivatives. PRP can induce a regenerative response and lead to the improvement of metabolic functions of damaged structures. However, the positive effect on c...
The role of platelet rich plasma in knee joint pain
Anaesthesia, Pain & Intensive Care
Osteoarthritis (OA) is a joint disorder is common worldwide. Pain and loss of function are the main clinical sign in knee joint OA that could come from periosteal nerve stretches, intraosseal hypertension, joint capsule stretches, intra-articular hypertension, ligament stretches, subchondral bone micro fracture, bursitis, and muscle spasm. Current therapy approach focuses on preventing progression and reducing symptoms by using a non-invasive procedure. Non-operative therapeutic intervention, that involves intra-articular injection in the knee joints, plays an important role in OA management. Platelet rich plasma (PRP) is a plasma fraction that contains concentrated platelets, has an autologue growth factor and high concentration of proteins that could improve healing process at cellular, tendon, ligament, muscle, as well as bone related tissue injury. Growth factor contained in PRP is responsible for anti-inflammatory effect through its inhibitory effect on Nuclear factor-kB (NFkB)...
Effectiveness of Platelet-ich Plasma Based on Gene Expression in Knee Osteoarthritis
2019
Background Intra-articular injection of Platelet-rich plasma (PRP) is an effective method for the treatment of patients with knee osteoarthritis (OA). This study aimed to assess the effects of PRP injection on OA, based on gene expression analysis. Methods A sample of 30 subjects with knee OA was asked to complete the Persian versions of the Intermittent and Constant Osteoarthritis Pain (ICOAP) and Knee and Osteoarthritis Outcome Score (KOOS). Thereafter, the expression of IGF-1, HIF-1, cartilage oligometric matrix protein (COMP), and bone morphogenetic proteins (BMP2) were compared in the patient before and 1 month after PRP injection using real-time polymerase chain reaction (PCR). Results According to the results of the study, the expression of IGF-1, HIF-1, COMP and BMP2 were reported to be higher in subjects with PRP injection; however, only the up-regulation of IGF-1 was statistically significant (P<007). Moreover, the significant change in the KOOS and ICOAP scores was att...
Role of platelet rich plasma in patients of osteoarthritis knee-a prospective study
IP Innovative Publication Pvt. Ltd, 2017
Introduction: In the present study, we evaluated the effects of 2 courses of PRP injections with 3 weeks interval, on patient's quality of life and functional ability. Materials and Method: It was a prospective study carried out on 55 patients (14 males & 41 females) in the Department of Orthopedics', Era's Lucknow Medical College, Lucknow, and Uttar Pradesh from Sep 2015 to March 2016. Age >40 years, Knee arthralgia (>3 months) and Radiologic evidence of articular damage (grades 1-3 of Kellgren-Lawrence scale) based on knee Osteoarthritis criteria of American College of Rheumatology were enrolled in our study. Two intra-articular injections of Platelet Rich Plasma (PRP) at 3 weeks interval was given and patient was regularly followed up after 3 rd week, 6 th week, 3 months & 6 months of the 1 st injection Results: Mean scores of all WOMAC parameters improved significantly compared to before treatment. Each Parameter of the WOMAC Score was compared with baseline score at each follow-up. Reduction in the mean pain, mean physical function and mean total womac scores from base line scores were observed during the course of 1 st (3 weeks) &2 nd (6 weeks) follow-ups then after marginal increase in scores were reported during 3 rd (3 months) and 4 th (6 months)follow ups but difference in mean of all scores were significant with the respective base line scores. Conclusion: The results of our study showed that intra-articular knee injections of Autologous Platelet Rich Plasma (PRP) are effective in reducing joint pain, stiffness and improve knee functions in early knee Osteoarthritis.
The Role of Platelet-rich Plasma in Osteoarthritis of Knee-joint
Scholars Journal of Applied Medical Sciences
Original Research Article Background: Osteoarthritis (OA) is a leading cause of disability and frequent visits to primary care practitioners for those with the condition in comparison to those without. OA affects the knee more often than any other joint of the human body. Platelet-rich plasma (PRP) which is also known as autologous conditioned plasma is a concentrate of platelet-rich plasma protein derived from whole blood, centrifuged to remove red blood cells. Now it is used in treating OA also. Aim of the study: The aim of this study was to evaluate the role of platelet-rich plasma in osteoarthritis of knee-joint. Materials and methods: This prospective observational study was conducted in the Department of Orthopaedics & Traumatology, TMSS Medical College, Bogura, Bangladesh during the period from January 2018 to December 2018. In total 120 patients more than 40 years of age, diagnosed with grade I and II arthritis were included in this study as the study population. To all the participants three PRP injections were injected in the knees at 4-week interval. Patients were followed up and were assessed for pain and physical activity associated with arthritis using the Western Ontario and McMaster University Arthritis Index (WOMAC) score at the time of induction in the study and at 6 months interval. Results: The mean WOMAC score before the starting of treatment was 82.94 (±5.12) and after 6 months it was reduced to 37.87 (±4.73), which was statistically significant (p= 0.0001). WOMAC score was improved more in the subgroup with patients having symptoms less than 2 years (p=0.0254). On the other hand, in case of subgroups with Kellgren-Lawrence grade 1 or 2 the p value was 0.0730 and there was not any significant difference in the WOMAC score at 6 months among males or females (p=0.1511). Conclusions: The proper sequential use of PRP injection for the treatment of osteoarthritis of knee-joint proved to be effective in our study. The findings of this study may be helpful in the treatment arena of osteoarthritis and in further similar researches.
Treatment With Platelet-Rich Plasma Is More Effective Than Placebo for Knee Osteoarthritis
The American Journal of Sports Medicine, 2013
Background: Specific growth factors have been proposed as therapeutic proteins for cartilage repair. Hypothesis: Platelet-rich plasma (PRP) provides symptomatic relief in early osteoarthritis (OA) of the knee. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 78 patients (156 knees) with bilateral OA were divided randomly into 3 groups. Group A (52 knees) received a single injection of PRP, group B (50 knees) received 2 injections of PRP 3 weeks apart, and group C (46 knees) received a single injection of normal saline. White blood cell (WBC)–filtered PRP with a platelet count 3 times that of baseline (PRP type 4B) was administered in all. All the groups were homogeneous and comparable in baseline characteristics. Clinical outcome was evaluated using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire before treatment and at 6 weeks, 3 months, and 6 months after treatment. They were also evaluated for pain by a visua...